Improving Patient Experience in Virginia Hospitals and Health Systems Thursday, July 23, 2020 12:00 p.m. – 12:30 p.m. Housekeeping • Webinar is being recorded • All participants are in listen-only mode • Ask questions or make comments by typing in the Questions box • Slides are available for download in the Handouts section of the webinar control panel • Slides and recordings will be available on the VHHA Quality & Safety website • Feedback survey will launch at conclusion of the webinar Today’s Agenda 1) VHHA Year of Patient Experience Overview and Webinar Objectives • Abraham Segres, VHHA 2) Patient Experience: Rapid Process Improvement and Patient Experience • Mary Mannix, CEO, Augusta Health • Crystal Farmer, RN, MSN, VP and CNO, Augusta Health 3) Polling, Discussion and Questions -Carrie Brady, VHHA Partner 4) Adjourn Vision Through the power of collaboration, the association will be the recognized driving force behind making Virginia the healthiest state in the nation. Mission Working with our members and other stakeholders, the Association will transform Virginia's health care system to achieve top-tier performance in safety, quality, value, service, and population health. The Association's leadership is focused on: improving access to care; continuing to improve health care safety, quality, and service; promoting a vibrant, high-value health care system; and, advancing population health to promote health and economic opportunity for all Virginians. VHHA Member Hospitals and Health Systems ▪ Augusta Health • Lake Taylor Transitional Care ▪ Ballad Health Hospital ▪ Bath Community Hospital • LifePoint Health ▪ Bon Secours Mercy Health • Mary Washington Healthcare ▪ Buchanan General Hospital • Novant Health UVA Health System ▪ Carilion Clinic • Riverside Health System ▪ Centra Health • Sentara Healthcare ▪ Chesapeake Regional Healthcare • Sheltering Arms ▪ Children’s Hospital of The King’s • Universal Health Services Daughters • University of Virginia Health System ▪ Children’s National Medical Center • Valley Health ▪ Encompass Health • VCU Health System ▪ HCA Virginia Health System • Vibra Hospital ▪ Inova Health System • Virginia Hospital Center Goals: 1) Identify: Identify, highlight and celebrate efforts by Virginia hospitals and health systems to improve the patient experience of care. 2) Integrate: Continue to link and integrate patient experience improvement efforts with broader quality and patient safety improvement efforts. 3) Connect: Facilitate connections between Virginia hospitals and health systems and other stakeholders for the purpose of shared learning. 4) Improve: Support efforts to improve Virginia hospitals’ individual and aggregate performance on national patient experience measures. Today’s Objectives: 1. Discuss the use of HCAHPS scores to guide improvement strategies 2. Review one hospital’s patient experience success sharing plan 3. Share insights from the impact of COVID-19 on deployment of key patient experience tactics Mary Mannix, FACHE Crystal Farmer, RN, MSN CEO, Augusta Health VP and CNO, Augusta Health Fishersville, VA Fishersville, VA JOURNEY TO PATIENT EXPERIENCE Rapid Process Improvement and Patient Experience Mary N. Mannix, FACHE, President & CEO Crystal Farmer, MSN, RN, NE-BC, Vice President & CNO Matthew Fidler, MA, Director of Patient Experience AUGUSTA HEALTH About Us •Independent, Non- Profit •Fishersville, VA •Licensed for 255 beds •ADC 150 •ED visits ~60,000 •17 off campus AH sites •Employed Physician Providers- 190 11 Patient Experience: Augusta Health 2018 ED Percentile Ranks Where Cleanliness / Quietness 29 Discharge Information 29 Communication with… 33 we started Communication with… 51 Would Recommend… 27 BACKGROUND: Overall Rating of Hospital 37 0 20 40 60 • Disconnect between quality, Inpatient Response finances, staff engagement Distribution and patient experience. 2018 2018 Inpatient Percentile Ranks 10 Best hospital possible Cleanliness / Quietness 33 9 47 Care Transitions 50 53 8 Communication About Meds 42 47 7 Communication with Doctors 60 34 Overall Rating of Hospital 39 0 20 40 60 0 20 40 60 80 12 Tactics 1 Start at the Front Door ED Wait Times, Triage Process 2 Hire for Fit Back to Basics 3 Nurse Leader Rounding | Uniform Code | Behavior Modeling | Communication 4 Re-Energize the Augusta Way Ritz-Carlton Partnership 5 Leverage Employee Shared Success Program 13 Nurse Leader Rounding Impact of NLR in the ED 2019 Dimension No Yes Difference Cleanliness/Quietness 70 88.8 18.8 Training Communication with Nurses 62.9 87.4 24.5 MyRounding Builds Accountability Classes taught by CNO/Director of Communication with Providers 67.6 88 20.4 Empowers leaders to take control Patient Experience Discharge Information 37.5 69.5 32 of their units Revalidation to ensure compliance. Overall Rating of Hospital 52.1 81.3 29.2 Would Recommend Facility 48.9 80.6 31.7 Impact of NLR in Inpatient 2019 Dimension No Yes Difference Care Transitions 35.6 56.4 20.8 Cleanliness/Quietness 51.3 66.8 15.5 Communication about Medication 36.3 68.7 32.4 Communication Communication about Pain 40.5 68.4 27.9 Engage Team Members Communication with Doctors 72 85.9 13.9 Build connections across systems at Every Level Communication with Nurses 66.7 84.9 18.2 Gives Patients a Voice Discharge Information 74.4 89.4 15 Ripple effect Building trust through transparency Overall Rating of Hospital 51.1 77.4 26.3 Responsiveness of Staff 54.1 73.5 19.4 Would Recommend Hospital 53.7 76.4 22.7 Leaders Back at Bedside 14 Is There a Secret Sauce? Verify and validate 1 every step of the way 2 Modeling the Behavior 3 Sharing the Stories 15 COVID-19: The Tree in the Road 16 What Did We Do Different? We took control over what we could during the uncontrollable Continued rounding in adaptive ways 1 Monitor Pulse of the Units, Virtual Sitter Platform Kept our patients connected and informed 2 Patient/Family Liaisons, Meal Cards, Facetime, Call Center We stepped up to make staff feel confident 3 Messages from Mary, Biweekly Townhalls, Transparent Communication, Safety Resource Officers 2020 Q2 Breakout VA Average Apr 2020 May 2020 Jun 2020 Total Top Box Top Box Top Box Top Box Top Box CAHPS Dimensions ED Overall Rating of Hospital 71.6 82 75.1 78.8 78.6 Inpatient Overall Rating of Hospital 74.8 78.9 77.9 80.0 79.0 17 Patient Experience: 2018-2020 ED Percentile Ranks Cleanliness /… Where Discharge… Communication… 2020 we stand Communication… 2019 Would… 2018 Overall Rating of… 0 50 100 Inpatient Response Distribution 2018-2020 Inpatient Percentile Ranks 10 Best hospital… 9 Cleanliness /… Care Transitions 8 2020 Communication… 7 2019 Communication with… 2018 0 20 40 60 Overall Rating of… 2020 2019 2018 0 20 40 60 80 100 QUESTIONS? 18 Polling Questions and Discussion Carrie Brady VHHA Patient Experience and HCAHPS Advisor 2020 Year of Patient Experience Leadership Patient and Staff Effective Use of Family Engagement Data Engagement Grounded in Four Essential Foundations for Success Polling Question #1: Using Data to Verify Process Impact • Do you validate the impact of specific processes/practices (e.g. nurse leader rounding) by comparing HCAHPS data for those patients who did and did not experience the process? – Yes If yes, please indicate in the chat – No box what processes/practices you have validated in this way. Polling Question #2: New Strategies to Connect Patients and Family • Since the onset of the pandemic, have you implemented any new communication strategies (e.g. liaison) to connect patients with their loved ones? – Yes If yes, please indicate in the chat – No box the strategies you have implemented. Polling Question #3: New Strategies to Support Staff • Since the onset of the pandemic, have you implemented any new strategies to support your staff? – Yes – No If yes, please indicate in the chat box the strategies you have implemented. It’s All Connected • HCAHPS questions are exclusively about the inpatient experience but patients don’t differentiate • Your “front doors” (ED, outpatient clinic/procedure, etc.), set the tone • The staff experience drives the patient experience Mobius Strip Upcoming Webinars Date/Time: Featured Presenter: August 27 Nathan Cunningham 12:00 noon Manager- Patient Experience & Department of Patient Centered Services, VCU Health Richmond, Virginia September 24 Insights from VHHA/Studer Group Collaborative 12:00 noon Five (5) Virginia Hospitals & Studer Coach Thank you!!.